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General NPI Number Information
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NPI Number | 1912672155
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Entity Type | Organization
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Legal Business Name | TRAVIS WEBB PSYCHOTHERAPY
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Dates
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Enumeration Date | 08/10/2021
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 5500 W PINNACLE POINTE DR STE 204
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City | ROGERS
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State | AR
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Zip | 72758-8153
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Country | US
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Telephone | 479-310-0233
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 W PINNACLE POINTE DR STE 204
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City | ROGERS
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State | AR
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Zip | 72758-8153
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Country | US
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Telephone | 479-310-0233
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TRAVIS WEBB
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Credential | LPC
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Telephone | 870-814-4780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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